adrenal glands Flashcards

1
Q

generally describe the adrenal cortex

A
  • outer portion of the adrenal gland
  • made of 3 layers
  • secrete steroid hormones
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2
Q

generally describe the adrenal medulla

A
  • inner portion of adrenal gland
  • produces amine hormones
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3
Q

where are mineralocorticoids secreted from

A

zona glomerulosa, outermost cortex layer (G)- 10% of volume

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4
Q

where are glucocorticoids secreted from

A

zona fasciculata, middle cortex layer (F) - 75% of volume

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5
Q

where are sex hormones secreted from

A

zona reticularis, inner layer of cortex (R) - 15% of volume

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6
Q

list the function of steroid hormones

A
  • mineralocorticoids: regulate salt balance
  • glucocorticoids: assist with carbohydrate metabolism
  • androgens: required for sexual function but less so than gonads
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7
Q

describe aldosterone

A
  • produced in G zone (outer layer)
  • controls salt and water retention
  • controlled by RAAS of kidney
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8
Q

describe the overall effect of aldosterone

A
  • vasoconstriction to increase BP
  • increased sodium retention and potassium excretion, increasing water retention
  • overall increases BP and BV
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9
Q

describe primary adrenal disease

A
  • aldosterone secreting adrenal adenoma = Conn syndrome
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10
Q

desrive secondary hyperaldosteronism

A
  • RAAS disorder produces excess renin
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11
Q

describe hypoaldosteronism

A
  • primary = Addison’s disease, atrophy o fadrenal glands w/ depressed production of aldosterone and glucocorticoids
  • congenital deficiency of 21-hydroxylase
  • decreased secretion of aldosterone and cortisol
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12
Q

describe variation of cortisol levels in the body

A

diurnal variation (ACTH same)

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13
Q

list the steps of cortisol regulation

A

1) hypothalamus (CRH)
2) anterior pituitary gland (ACTH)
3) adrenal glands (cortisol)
- negative feedback loop

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14
Q

describe primary hyperadrenalism

A

adrenal gland misfunction causing increased cortisol release with low ACTH and CRH

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15
Q

describe secondary hyperadrenalism

A

pituitary gland misfunction causing excess ACTH release and subsequent cortisol release
- also referred to as Cushings disease

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16
Q

what test can be run to differentiate eptopic tumor vs secondary hypoadrenalism

A

dexamethasone suppression
- inhibits production of ACTH from pituitary gland

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17
Q

what is the difference between cushing’s syndrome and cushings disease

A
  • disease is secondary hyperadrenalism
  • syndrome is a general term for cortisol excess
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18
Q

describe tertiary hyperadrenalism

A

hypothalamus misfunction causing excess release of CRH which leads to excess cortisol and ACTH

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19
Q

what are catecholamines synthesized from and where

A

made in adrenal medulla from tyrosine
- include epinephrine, norepinephrine and dopamine

20
Q

describe the function of epinephrine

A

converts glycogen to glycose for greater work output

21
Q

describe function of norepinephrine

A

neurotransmitter affecting vascular smooth muscle and heart

22
Q

describe function of dopamine

A

neurotransmitter in the brain affecting vascular system

23
Q

what is the metabolite of dopamine

A

homovanillic acid

24
Q

what is the metabolite and final product of norepinephrine metabolism

A
  • normetanephrine metabolite
  • vanillylmandelic acid
25
Q

what is the metabolite and final product of epinephrine metabolism

A
  • metanephrine metabolite
  • vanillylmandelic acid
26
Q

describe pheochromocytoma

A

a tumor of the adrenal medulla causing increased epinephrine and norepinephrine

27
Q

describe neuroblastoma

A

tumor of the adrenal medulla (in kids) causing epinephrine, norepinephrine and dopamine excess
- increased HVA and VMA urinary excretion (metabolism end products)

28
Q

define adrenal incidentaloma

A

an adrenal mass > 1 cm discovered via imaging for nonadrenal pathology

29
Q

true or false
the testes are a part of the hypothalamic-pituitary-gonadal axis

A

true

30
Q

how is testosterone related to LH and FSH

A

LH and FSH are released by anterior pituitary gland and inhibited by increased levels of testosterone

31
Q

describe congenital adrenal hyperplasia (CAH)

A

caused by 21-hydroxylase deficiency that prevents cortisol production

32
Q

describe hyperandrogenemia

A

can cause precocious puberty in males and development of male secondary sex characteristic in female children

33
Q

describe primary hypoandrogenemia

A

called klinefelter syndrome (XXY), decreased amounts of testosterone produced

34
Q

describe secondary hypoandrogenemia

A

pituitary or hypothalamus disorder causing decreased synthesis of LH and FSH

35
Q

describe estrogen and progesterone impact on LH and FSH formation

A

estrogen and progesterone have a negetive feeback control on LH and FSH

36
Q

describe estrogen
- secretion
- differeing forms
- principle form

A
  • secreted by ovarian follicles and placenta
  • estradiol-17beta, esterone and estradiol
  • estradiol is primary estrogen made by ovaries
37
Q

describe function of progesterone

A

secreted by corpus luteum after ovulation
- increased in luteal phase
- decreased in follicular phase

38
Q

what is the role of FSH in the first half of the menstrual cycle

A

promotes growth of ovarian follicles and increases estrogen

39
Q

how does an increase of estrogen impact LH midcyle

A

decreases LH and FSH levels (negative feedback)

40
Q

what hormone triggers ovulation

A

LH

41
Q

what does the follicle become during menstrual cycle

A

following ovulation the follicle becomes the corpus luteum which produces estrogen and progesterone

42
Q

if there is no fertilization during the menstral cycle what occurs

A
  • lack of hCG (fertilization) causes corpus luteum to degenerate
  • decreases in estrogen and progesterone
43
Q

what characterizes the follicular phase of menstration

A

estrogen stimulates growth of uterine lining
low levels of progesterone

44
Q

what characterises the luteal phase of the menstrual cycle

A

progesterone promotes endometrium tissue to accept fertilized egg
progesterone measurements are used to confirm ovulation period

45
Q

describe hyperestrinism

A

causes precocious puberty in females and testicular atrophy in males

46
Q

how can progesterone impact menstrual cycle in increased and decreased levels

A
  • malignant increase prevents menstrual cycle from occurring
  • malignant decrease causes infertility and abortion of fetus